Kottschade Lisa, Brys Adam, Peikert Tobias, Ryder Mabel, Raffals Laura, Brewer Jerry, Mosca Paul, Markovic Svetomir
Division of aMedical Oncology bPulmonary and Critical Care Medicine cEndocrinology dGastroenterology and Hepatology eDermatology fHematology, Mayo Clinic, Rochester, Minnesota gDuke University School of Medicine hDivision of Advance Oncologic and GI Surgery, Duke University, Durham, North Carolina, USA.
Melanoma Res. 2016 Oct;26(5):469-80. doi: 10.1097/CMR.0000000000000273.
Immune-related Adverse Events (irAEs) are the most significant toxicities associated with the use of checkpoint inhibitors, and result from disinhibition of the host's immune homeostasis. The adverse effects experienced from immunotherapy are significantly different from those of chemotherapy and, to a lesser extent, targeted therapy. Early recognition and diagnosis of these toxicities is often challenging, but is critically important because of the potentially life-threatening nature and associated morbidity. Gastrointestinal, dermatologic, endocrine, and liver toxicities are the most commonly observed. Less commonly, the eyes, pancreas, kidneys, lungs, bone marrow, or nervous system may be affected. Although most irAEs may resolve with supportive care or discontinuation of drug, in severe cases, they may require hospitalization and immune suppressants, such as steroids, and/or may even cause death. The management of immune-related side effects requires a multidisciplinary approach.
免疫相关不良事件（irAEs）是与使用检查点抑制剂相关的最显著毒性反应，由宿主免疫稳态的去抑制作用导致。免疫疗法所产生的不良反应与化疗显著不同，在较小程度上也与靶向治疗不同。这些毒性反应的早期识别和诊断往往具有挑战性，但由于其潜在的危及生命的性质和相关发病率，至关重要。胃肠道、皮肤、内分泌和肝脏毒性是最常观察到的。较少见的情况下，眼睛、胰腺、肾脏、肺、骨髓或神经系统可能会受到影响。尽管大多数免疫相关不良事件通过支持治疗或停药可能会缓解，但在严重情况下，可能需要住院治疗并使用免疫抑制剂，如类固醇，和/或甚至可能导致死亡。免疫相关副作用的管理需要多学科方法。
